Individual
COURTNEY BOYDE CRIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3510 N HIGHWAY 17 STE 105, MT PLEASANT, SC 29466-8228
(843) 789-1850
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1880
SC
363AS0400X
Surgical Physician Assistant
50.002498
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1593PA
—
SC
Enumeration date
10/03/2006
Last updated
01/03/2025
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